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Judge Rules Health Law Is Constitutional

A federal judge in Michigan on Thursday dismissed one of more than 15 legal challenges to the new health care law, becoming the first to rule that the law is constitutional.

Two other cases with higher profiles, one in Florida and one in Virginia, are headed toward hearings on the issues that were decided in Michigan. The central question, which may ultimately fall to the Supreme Court, is whether the Commerce Clause of the Constitution gives Congress the authority to require citizens to obtain a commercial product, namely health insurance.

Starting in 2014, the law will require most Americans to obtain health insurance, while prohibiting insurers from denying coverage to those with pre-existing conditions.

Judge George C. Steeh of Federal District Court in Detroit ruled that choosing not to obtain insurance qualified as an example of “activities that substantially affect interstate commerce.” That is the standard set by the Supreme Court for Congress’s compliance with the Commerce Clause.

Judge Steeh, who was appointed by President Bill Clinton, agreed with the federal government that not obtaining health coverage is effectively an active decision to pay for medical care out of pocket. “These decisions, viewed in the aggregate,” Judge Steeh wrote, “have clear and direct impacts on health care providers, taxpayers and the insured population who ultimately pay for the care provided to those who go without insurance.”

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The judge wrote that the challenge, which was brought by several Michigan residents and the Thomas More Law Center, a conservative group, “arguably presents an issue of first impression,” meaning it would be the first time the courts had considered it. But he ruled that there was “a rational basis to conclude” that decisions to forgo insurance drive up the cost of coverage and thus affect interstate commerce.

“This ruling marks the first time a court has considered the merits of any challenge to this law,” said Tracy Schmaler, a spokeswoman for the Justice Department, “and we welcome the court’s decision upholding the health care reform statute as constitutional.”

Robert J. Muise, senior trial counsel of the Thomas More Law Center, said the case was “set up nicely for appeal.”

The judge in the Florida lawsuit, which was filed by elected officials in 20 states, is expected to allow a hearing on the merits that has been scheduled for Dec. 16. The Virginia case, filed by the state attorney general, is scheduled for a hearing on Oct. 18.

A version of this article appears in print on October 8, 2010, on Page A15 of the New York edition with the headline: Judge Rules Health Law Is Constitutional. Order Reprints|Today's Paper|Subscribe